Last autumn, members of the PRIME executive were invited to present some of our basic material in induction courses and grand rounds at NHS hospitals in the south of England where there is great concern about burnout particularly of junior doctors. Previously Dr John Caroe (chair of
trustees of PRIME) and I had been invited to a conference at the Royal College of Psychiatrists for younger doctors who had suffered severe burnout. In round table discussions they shared problems contributing to their burnout. Simply by talking together several ways of reducing some of these factors were identified. This demonstrated so powerfully that we must care for those we work alongside as well as our patients. However, one factor stood out to me – one of them said ‘loss of humanity’ and many others concurred.
It reminded me of a conversation I had with a young student in eastern Europe. She was expressing the idealism of herself and her friends. I warned her to guard this carefully and never lose it. “No, we won’t ever lose it,” she replied. I asked her how many of the hospital doctors she knew had this idealism. She thought, and then replied, “None – they are all…” she paused, struggling for the word, “…inhuman.”
An article by one of my heroes, Professor John Wyatt, entitled, “The Machine Will See You Now”(1) brought this conversation to mind. In it he looks at both the advantages and the possible consequences of the increasing role of Artificial Intelligence and robotics in medical systems, and the danger of a growing tendency to see the human being as an intelligent robot made of meat.
The article made me ponder the nature of ‘humanity’ – what does it mean to be human and part of a wider humanity, and what responsibilities does that impose on us as healthcare professionals – or aspiring-to-be healthcare professionals?
We have talked a lot about compassion and how essential it is both for patients and those who treat them. We are delighted that though the work of PRIME hundreds, possibly thousands, of healthcare professionals and students have stated their intention to be more compassionate in their practice – and teach others to be so. Dr David Chaput de Saintonge, who played such a vital role in the development of PRIME, spoke of compassion in the light of the Biblical command to “Love your neighbour as yourself” as identifying with your patient so closely that his or her needs become your needs and in so doing drive you to seek the very best outcome for them.
But is there a further, deeper responsibility for us? Is it enough to care for those directly in front of us – and who we have chosen to care for by our choice of location?
Healthcare is a vocation (literally ‘a calling’ from the Latin vocare). Does being called into healthcare bestow a responsibility to improve the health of more than the patients in our direct care. Do we perhaps need to ask, as we approach the turn of the year, whether our calling bestows not only a responsibility to be passionate about those patients in front of us, but also those not under our care and possibly not even in our own country.
Compassion can be defined as being able to align ourselves deeply with the patient, their concepts and emotions (empathy), and with the drive to do something for them. But maybe, having the privilege of being called into, and serving in, healthcare imposes an even greater responsibility – to develop a passion to see everyone, everywhere being able to access this compassionate care. Even more – to take upon ourselves, individually and collectively, to act against the conditions that cause illnesses and especially the problems faced by the poor of the world. Against world systems that mean a premature baby in richer countries can receive care at a cost of around £1500 per day (2), whilst in the same world around 29,000 children under five die every day (3) mainly due to poverty, poor social conditions and lack of affordable healthcare.
We can all play a role in working to achieve a better, fairer world. Healthcare professionals are still afforded a respect which gives us a powerful voice. The question is – will we look for opportunities to work with others to achieve a more humane world, to make the voice of humanity for humanity heard more loudly? Perhaps we should make our slogan for 2018: Restoring humanity to healthcare to improve healthcare for humanity – everywhere.
Maybe I will leave the last word to Marie Curie (inventor of X-ray radiology): You cannot hope to build a better world without improving the individuals. To that end, each of us must work for his own improvement and, at the same time, share a general responsibility for all humanity, our particular duty being to aid those to whom we think we can be most useful.
On behalf of the PRIME team here may I wish you all God’s richest blessings in the coming year.
John Geater Founder and International Director
1. Wyatt J : The machine will see you now https://www.cmf.org.uk/resources/publications/content/?context=article&id=26666